tbuckley/cabot-search huggingface dataset:
Pseudo-athletic appearance from excess alcohol use
Authors: Chun-Yu Cheng
Journal: BMJ (2023)

Pseudo-athletic appearance from excess alcohol use Chun-Yu Cheng attending physicianThese are symmetrical slow growing soft masses over the neck, shoulders, and upper back of a man in his 50s (fig 1).The lesions, resembling muscular physique, had been present for five years.The patient reported alcohol consumption of 10 units a day [one unit equals 8 g of pure alcohol] for more than 20 years.Ultrasonography showed multiple subcutaneous isoechoic masses without posterior enhancement or acoustic shadow, suggesting lipomatosis.Blood glucose levels, lipid profile, and liver, renal, and thyroid function were within normal limits.Multiple symmetrical lipomatosis, also known as Madelung's disease, has been associated with excess alcohol use. 1 The condition might be caused by alcohol induced dysfunction of adrenergic lipolysis, leading to uncontrolled accumulation of adipose tissue. 2Fig 1
Aeromonas spp. from hospital sewage act as a reservoir of genes resistant to last-line antibiotics
Authors: Yuchen Wu, Ning Dong, Chang Cai, Yu Zeng, Jiayue Lu, Congcong Liu, Hanyu Wang, Yanyan Zhang, Ling Huang, Weishuai Zhai, Dongyan Shao, Ruichao Li, Dejun Liu, Sheng Chen, Rong Zhang
Journal: Drug Resistance Updates (2023)
Comprehensive Phenotypic Characterization of Late Gadolinium Enhancement Predicts Sudden Cardiac Death in Coronary Artery Disease
Authors: Richard E. Jones, Hassan A. Zaidi, Daniel J. Hammersley, Suzan Hatipoglu, Ruth Owen, Gabriel Balaban, Antonio de Marvao, François Simard, Amrit S. Lota, Ciara Mahon, Batool Almogheer, Lukas Mach, Francesca Musella, Xiuyu Chen, John Gregson, Laura Lazzari, Andrew Ravendren, Francisco Leyva, Shihua Zhao, Ali Vazir, Pablo Lamata, Brian P. Halliday, Dudley J. Pennell, Martin J. Bishop, Sanjay K. Prasad
Journal: JACC. Cardiovascular imaging (2023)

Late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) offers the potential to noninvasively characterize the phenotypic substrate for sudden cardiac death (SCD).
Prognostic Value of Late Gadolinium Enhancement Detected on Cardiac Magnetic Resonance in Cardiac Sarcoidosis
Authors: Alexander Stevenson, Jonathan J.H. Bray, Laura Tregidgo, Mahmood Ahmad, Anika Sharma, Alexander Ng, Atif Siddiqui, Ali A. Khalid, Keiran Hylton, Adrian Ionescu, Rui Providencia, Ali Kirresh
Journal: JACC. Cardiovascular imaging (2023)
Influenza Vaccine in Pediatric Recipients of Hematopoietic-Cell Transplants
Authors: Jennifer E Schuster, Lubna Hamdan, Daniel E Dulek, Carrie L Kitko, Einas Batarseh, Zaid Haddadin, Laura S Stewart, Anna Stahl, Molly Potter, Herdi Rahman, Spyros A Kalams, Susan Coffin, Monica I Ardura, Rachel L Wattier, Gabriela Maron, Claire E Bocchini, Elizabeth A Moulton, Michael Grimley, Grant Paulsen, Christopher J Harrison, Jason Freedman, Paul A Carpenter, Janet A Englund, Flor M Munoz, Lara Danziger-Isakov, Andrew J Spieker, Natasha Halasa
Journal: New England Journal of Medicine (2023)

To the Editor: Pediatric recipients of hematopoietic-cell transplants (HCT) are at high risk for influenza-related illness and death.They also have weaker humoral immune responses to influenza vaccination than healthy children, which suggests that alternative vaccine regimens are needed. 1Previous phase 1 studies showed that high-dose influenza vaccines are immunogenic in some high-risk populations without evident safety concerns, but data are lacking for pediatric recipients of HCT. 2-4 We conducted a phase 2, multicenter, doubleblind, randomized, controlled trial (Pediatric HCT Flu Study; ClinicalTrials.govnumber, NCT02860039) that compared immunogenicity and safety between high-dose trivalent influenza vaccine (HD-TIV) and standard-dose quadrivalent influenza vaccine (SD-QIV) in children and adolescents 3 to 17 years of age who had received an allogeneic HCT 3 to 35 months earlier.The trial was conducted over three influenza seasons (2016 through 2019).The protocol (available with the full text of this letter at NEJM.org) was approved by the institutional review board at each site, and writ-
When Weight Impacts Health
Authors: Louis J. Aronne, Sarah Bramblette, Julie R. Ingelfinger, Ania M. Jastreboff, Sriram Machineni, Nikki Massie, Clifford J. Rosen
Journal: New England Journal of Medicine (2023)

In this short video for patients and families from the New England Journal of Medicine, experts discuss the current understanding of obesity and explore the surgical and medical therapies for weight loss, with a focus on new, effective treatments. Patients also share their experiences with bias and stigma and their reflections on living with obesity.
Port-Site Metastasis Identified on Prostate-Specific Membrane Antigen–Targeted 18F-DCFPyL PET/CT After Robot-Assisted Laparoscopic Radical Prostatectomy
Authors: Hanan Zahed, Jerome Laufer, Martin LeBlanc, Steven Tisseverasinghe, Tamim Niazi, Stephan Probst
Journal: Clinical Nuclear Medicine (2023)

Port-site metastasis is an extremely rare complication following minimally invasive oncologic surgery for prostate cancer. We present the case of a 74-year-old man who underwent robot-assisted laparoscopic radical prostatectomy followed by salvage radiotherapy. Despite treatment, he developed biochemical recurrence. However, there was no evidence of disease on CT and bone scan at a prostate-specific antigen of 4.6 ng/mL. Subsequently, 18 F-DCFPyL PET/CT revealed a solitary focus of intense uptake in the right rectus abdominis muscle that was felt to represent a port-site metastasis. Histopathologic evaluation with immunostaining following ultrasound-guided needle biopsy confirmed the presence of metastatic adenocarcinoma of the prostate.
Cancer gene therapy bears fruit
Authors: Timothy P. Cripe
Journal: Molecular Therapy (2023)

As a first-year clinical fellow in 1992, my classmate and now well-known pediatric neuro-oncologist, Mark Kieran, convinced our program director to send the two of us to the First International Conference on Gene Therapy of Cancer held at the Hotel del Coronado in San Diego. I was already armed with a PhD in genetics, and the nascent field of gene therapy had piqued my interest. The conference was truly an eye-opener; I was absolutely stunned and thoroughly excited by the plethora of creative ideas being discussed to use genes as cancer treatment. Although delivery methods ranged from naked DNA to DNA-coated gold beads shot from a “gene gun,” the most common method was replication-defective adenovirus vectors. Fast forward 30 years, and we finally have achieved the first such adenovirus-based gene therapy FDA approved for cancer. 1 Kiem H.P. FDA approves first gene therapy for bladder cancer. https://asgct.org/publications/news/december-2022/fda-approves-first-gene-therapy-for-bladder-cancerDate: 2022 Google Scholar
Generalized Muscular Hypermetabolism Caused by Mitochondrial Myopathy Shown on 18F-FDG PET/CT
Authors: Menglin Liang, Meiqi Wu, Chenhao Jia, Ruijie Guo, Ruixue Cui
Journal: Clinical Nuclear Medicine (2023)

An 18-year-old man presented with progressive exercise intolerance and muscle weakness for 1 year with recent acute exacerbation. Laboratory test demonstrated lactic acidosis. 18 F-FDG PET/CT was performed to exclude malignancy and showed generalized muscular hypermetabolism. Muscle biopsy combined with patient's history suggested mitochondrial myopathy. This report illustrates that mitochondrial myopathy may present as generalized muscular hypermetabolism on 18 F-FDG PET/CT and thus should be added to the differential diagnoses.
Altered Biodistribution on 99mTc-Dimercaptosuccinic Acid Renal Scan
Authors: Megan K. Mercer, Marguerite T. Parisi, Jonathan W. Revels, Lisa Blacklock, Saeed Elojeimy
Journal: Clinical Nuclear Medicine (2023)

99m Tc-dimercaptosuccinic acid ( 99m Tc-DMSA) scans are used to evaluate renal cortical defects typically related to parenchymal scarring or pyelonephritis, and ectopic renal parenchyma. 99m Tc-DMSA binds to metalloproteins in proximal tubular cells and typically localizes to the renal cortex, with minimal excretion. Planar and SPECT images are obtained 2 to 4 hours after IV administration of 99m Tc-DMSA. Altered 99m Tc-DMSA biodistribution has been reported in various conditions, including renal injury, technical issues, infiltrative processes, and hematologic disorders. Here, we present a case of altered biodistribution, with hepatic and splenic radiotracer uptake in the setting of hepatosplenomegaly and hematologic abnormalities concerning for a systemic hematologic disorder/lymphohistiocytosis.
Intense Axillary Accumulation of 99mTc-MDP Due to Perspiration
Authors: Linlin Guo, Lili Pan, Guohua Shen
Journal: Clinical Nuclear Medicine (2023)

Prostate cancer was newly diagnosed in a 73-year-old man. He underwent bone scintigraphy to assess any skeletal involvement. No abnormal uptake was observed in the skeletal system, whereas intense radioactivity was seen in the bilateral axillary regions. Physical examination found large amounts of sweat. Repeat images revealed no axillary activity after washing. This case illustrated axillary accumulation of 99m Tc-MDP due to perspiration.
Systemic interindividual epigenetic variation in humans is associated with transposable elements and under strong genetic control
Authors: Chathura J. Gunasekara, Harry MacKay, C. Anthony Scott, Shaobo Li, Eleonora Laritsky, Maria S. Baker, Sandra L. Grimm, Goo Jun, Yumei Li, Rui Chen, Joseph L. Wiemels, Cristian Coarfa, Robert A. Waterland
Journal: Genome biology (2023)

Abstract Background Genetic variants can modulate phenotypic outcomes via epigenetic intermediates, for example at methylation quantitative trait loci (mQTL). We present the first large-scale assessment of mQTL at human genomic regions selected for interindividual variation in CpG methylation, which we call correlated regions of systemic interindividual variation (CoRSIVs). These can be assayed in blood DNA and do not reflect interindividual variation in cellular composition. Results We use target-capture bisulfite sequencing to assess DNA methylation at 4086 CoRSIVs in multiple tissues from each of 188 donors in the NIH Gene-Tissue Expression (GTEx) program. At CoRSIVs, DNA methylation in peripheral blood correlates with methylation and gene expression in internal organs. We also discover unprecedented mQTL at these regions. Genetic influences on CoRSIV methylation are extremely strong (median R 2 =0.76), cumulatively comprising over 70-fold more human mQTL than detected in the most powerful previous study. Moreover, mQTL beta coefficients at CoRSIVs are highly skewed (i.e., the major allele predicts higher methylation). Both surprising findings are independently validated in a cohort of 47 non-GTEx individuals. Genomic regions flanking CoRSIVs show long-range enrichments for LINE-1 and LTR transposable elements; the skewed beta coefficients may therefore reflect evolutionary selection of genetic variants that promote their methylation and silencing. Analyses of GWAS summary statistics show that mQTL polymorphisms at CoRSIVs are associated with metabolic and other classes of disease. Conclusions A focus on systemic interindividual epigenetic variants, clearly enhanced in mQTL content, should likewise benefit studies attempting to link human epigenetic variation to the risk of disease.
Comparative outcomes of extracorporeal membrane oxygenation for COVID-19 delivered in experienced European centres during successive SARS-CoV-2 variant outbreaks (ECMO-SURGES): an international, multicentre, retrospective cohort study
Authors: Matthieu Schmidt, David Hajage, Micha Landoll, Benjamin Pequignot, Elise Langouet, Matthieu Amalric, Armand Mekontso-Dessap, Luis Chiscano-Camon, Katy Surman, Dylan Finnerty, Patricia Santa-Teresa, Antonio Arcadipane, Pablo Millán, Roberto Roncon-Albuquerque, Aaron Blandino-Ortiz, Pablo Blanco-Schweizer, Pilar Ricart, Ricardo Gimeno-Costa, Carlos Luis Albacete, Philip Fortuna, Peter Schellongowski, Dieter Dauwe, Hadrien Winiszewski, Antoine Kimmoun, Bruno Levy, Greet Hermans, Giacomo Grasselli, Guillaume Lebreton, Christophe Guervilly, Gennaro Martucci, Christian Karagiannidis, Jordi Riera, Alain Combes
Journal: The Lancet Respiratory Medicine (2023)
Withdrawal of infliximab or concomitant immunosuppressant therapy in patients with Crohn's disease on combination therapy (SPARE): a multicentre, open-label, randomised controlled trial
Authors: Edouard Louis, Matthieu Resche-Rigon, David Laharie, Jack Satsangi, Nik Ding, Britta Siegmund, Geert D'Haens, Laurence Picon, Peter Bossuyt, Lucine Vuitton, Peter Irving, Stephanie Viennot, Christopher A Lamb, Richard Pollok, Filip Baert, Maria Nachury, Mathurin Fumery, Cyrielle Gilletta, Sven Almer, Shomron Ben-Horin, Yoram Bouhnik, Jean-Frederic Colombel, Erik Hertervig, Jane Andrews, Miles Sparrow, Rupert Leong, Susan Connor, Graham Radforth-Smith, Peter De Cruz, Jan Preiss, Andrea Stallmach, Thomas Liceni, Olaf Grip, Jonas Halfvarson, Dharmaraj Durai, Fraser Cummings, Christian Seilinger, Miles Parkes, James Lindsay, Guy Lambrecht, Philippe Van Hootegem, Jean-François Rahier, Marie Dewitte, Xavier Hebuterne, Elise Chanteloup, Romain Altwegg, Stephane Nancey, Guillaume Bouguen, Guillaume Pineton de Chambrun, Floriant Poullenot, Xavier Roblin
Journal: The Lancet. Gastroenterology & hepatology (2023)
Portal hypertension and variceal bleeding in patients with liver cancer: Evidence gaps for prevention and management
Authors: Manon Allaire, Dominique Thabut
Journal: Hepatology (2023)

Portal hypertension (PHT) and HCC are 2 major complications of cirrhosis that often coexist in the same patient and impact the prognosis, especially in patients with acute variceal bleeding. In this review, we aim to discuss the best strategy for PHT screening and primary prophylaxis, as well as the management of acute variceal bleeding, to improve the management of PHT in HCC patients.
Long covid outcomes at one year after mild SARS-CoV-2 infection: nationwide cohort study
Authors: Barak Mizrahi, Tamar Sudry, Natalie Flaks-Manov, Yoav Yehezkelli, Nir Kalkstein, Pinchas Akiva, Anat Ekka-Zohar, Shirley Shapiro Ben David, Uri Lerner, Maytal Bivas-Benita, Shira Greenfeld
Journal: BMJ (2023)

Abstract Objectives To determine the clinical sequelae of long covid for a year after infection in patients with mild disease and to evaluate its association with age, sex, SARS-CoV-2 variants, and vaccination status. Design Retrospective nationwide cohort study. Setting Electronic medical records from an Israeli nationwide healthcare organisation. Population 1 913 234 Maccabi Healthcare Services members of all ages who did a polymerase chain reaction test for SARS-CoV-2 between 1 March 2020 and 1 October 2021. Main outcome measures Risk of an evidence based list of 70 reported long covid outcomes in unvaccinated patients infected with SARS-CoV-2 matched to uninfected people, adjusted for age and sex and stratified by SARS-CoV-2 variants, and risk in patients with a breakthrough SARS-CoV-2 infection compared with unvaccinated infected controls. Risks were compared using hazard ratios and risk differences per 10 000 patients measured during the early (30-180 days) and late (180-360 days) time periods after infection. Results Covid-19 infection was significantly associated with increased risks in early and late periods for anosmia and dysgeusia (hazard ratio 4.59 (95% confidence interval 3.63 to 5.80), risk difference 19.6 (95% confidence interval 16.9 to 22.4) in early period; 2.96 (2.29 to 3.82), 11.0 (8.5 to 13.6) in late period), cognitive impairment (1.85 (1.58 to 2.17), 12.8, (9.6 to 16.1); 1.69 (1.45 to 1.96), 13.3 (9.4 to 17.3)), dyspnoea (1.79 (1.68 to 1.90), 85.7 (76.9 to 94.5); 1.30 (1.22 to 1.38), 35.4 (26.3 to 44.6)), weakness (1.78 (1.69 to 1.88), 108.5, 98.4 to 118.6; 1.30 (1.22 to 1.37), 50.2 (39.4 to 61.1)), and palpitations (1.49 (1.35 to 1.64), 22.1 (16.8 to 27.4); 1.16 (1.05 to 1.27), 8.3 (2.4 to 14.1)) and with significant but lower excess risk for streptococcal tonsillitis and dizziness. Hair loss, chest pain, cough, myalgia, and respiratory disorders were significantly increased only during the early phase. Male and female patients showed minor differences, and children had fewer outcomes than adults during the early phase of covid-19, which mostly resolved in the late period. Findings remained consistent across SARS-CoV-2 variants. Vaccinated patients with a breakthrough SARS-CoV-2 infection had a lower risk for dyspnoea and similar risk for other outcomes compared with unvaccinated infected patients. Conclusions This nationwide study suggests that patients with mild covid-19 are at risk for a small number of health outcomes, most of which are resolved within a year from diagnosis.
Guidelines of care for the management of atopic dermatitis in adults with topical therapies
Authors: Robert Sidbury, Ali Alikhan, Lionel Bercovitch, David E. Cohen, Jennifer M. Darr, Aaron M. Drucker, Lawrence F. Eichenfield, Lindsy Frazer-Green, Amy S. Paller, Kathryn Schwarzenberger, Jonathan I. Silverberg, Anne Marie Singh, Peggy A. Wu, Dawn M.R. Davis
Journal: Journal of the American Academy of Dermatology (2023)
Recent Advances in the Role of Autophagy in Endocrine-Dependent Tumors
Authors: Anvita Komarla, Suzanne Dufresne, Christina G Towers
Journal: Endocrine Reviews (2023)

Abstract Autophagy plays a complex role in several cancer types, including endocrine-dependent cancers, by fueling cellular metabolism and clearing damaged substrates. This conserved recycling process has a dual function across tumor types where it can be tumor suppressive at early stages but tumor promotional in established disease. This review highlights the controversial roles of autophagy in endocrine-dependent tumors regarding cancer initiation, tumorigenesis, metastasis, and treatment response. We summarize clinical trial results thus far and highlight the need for additional mechanistic, preclinical, and clinical studies in endocrine-dependent tumors, particularly in breast cancer and prostate cancer.
Our shared responsibility: the urgent necessity of global environmentally sustainable kidney care
Authors: Caroline E. Stigant, Katherine A. Barraclough, Mark Harber, Nigel S. Kanagasundaram, Charu Malik, Vivekanand Jha, Raymond C. Vanholder
Journal: Kidney International (2023)

In response to Earth's accelerating climate crisis, we, an international group of nephrologists, call on our global community to unite and align kidney care in accordance with United Nation's 26th Conference of the Parties health sector principles. We announce a global and inclusive initiative, "GREEN-K": Global Environmental Evolution in Nephrology and Kidney Care, with a vision of "sustainable kidney care for a healthy planet and healthy kidneys" and mission to "promote and support environmentally sustainable and resilient kidney care globally through advocacy, education, and collaboration." A patient-centric approach that permits climate change mitigation and adaptation is proposed. Multi-stakeholder GREEN-K action and focus areas will include education, sustainable clinical care, and advances toward environmentally sustainable innovations, procurement, and infrastructure. Mindful of the disproportionately high climate impact of kidney therapies, we welcome the opportunity to work together in shared accountability to patients and Earth's natural systems.
Supramolecular approaches for insulin stabilization without prolonged duration of action
Authors: Rolande Meudom, Yanxian Zhang, Michael A. VandenBerg, Lei Zou, Yi Wolf Zhang, Matthew J. Webber, Danny Hung-Chieh Chou
Journal: Acta Pharmaceutica Sinica B (2023)

Aggregation represents a significant challenge for the long-term formulation stability of insulin therapeutics. The supramolecular PEGylation of insulin with conjugates of cucurbit[7]uril and polyethylene glycol (CB[7]‒PEG) has been shown to stabilize insulin formulations by reducing aggregation propensity. Yet prolonged in vivo duration of action, arising from sustained complex formation in the subcutaneous depot, limits the application scope for meal-time insulin uses and could increase hypoglycemic risk several hours after a meal. Supramolecular affinity of CB[7] in binding the B1-Phe residue on insulin is central to supramolecular PEGylation using this approach. Accordingly, here we synthesized N-terminal acid-modified insulin analogs to reduce CB[7] interaction affinity at physiological pH and reduce the duration of action by decreasing the subcutaneous depot effect of the formulation. These insulin analogs show weak to no interaction with CB[7]‒PEG at physiological pH but demonstrate high formulation stability at reduced pH. Accordingly, N-terminal modified analogs have in vitro and in vivo bioactivity comparable to native insulin. Furthermore, in a rat model of diabetes, the acid-modified insulin formulated with CB[7]‒PEG offers a reduced duration of action compared to native insulin formulated with CB[7]‒PEG. This work extends the application of supramolecular PEGylation of insulin to achieve enhanced stability while reducing the risks arising from a subcutaneous depot effect prolonging in vivo duration of action.
The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review
Authors: Zobair M. Younossi, Pegah Golabi, James M. Paik, Austin Henry, Catherine Van Dongen, Linda Henry
Journal: Hepatology (2023)

Background and Aims: NAFLD is a leading cause of liver-related morbidity and mortality. We assessed the global and regional prevalence, incidence, and mortality of NAFLD using an in-depth meta-analytic approach. Approach and Results: PubMed and Ovid MEDLINE were searched for NAFLD population-based studies from 1990 to 2019 survey year (last published 2022) per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Meta-analysis was conducted using random-effects models. Bias risk assessment was per Joanna Briggs Institute. Of 2585 studies reviewed, 92 studies (N=9,361,716) met eligibility criteria. Across the study period (1990–2019), meta-analytic pooling of NAFLD prevalence estimates and ultrasound-defined NAFLD yielded an overall global prevalence of 30.05% (95% CI: 27.88%–32.32%) and 30.69% (28.4–33.09), respectively. Global NAFLD prevalence increased by +50.4% from 25.26% (21.59–29.33) in 1990–2006 to 38.00% (33.71–42.49) in 2016–2019 ( p &lt;0.001); ultrasound-defined NAFLD prevalence increased by +38.7% from 25.16% (19.46–31.87) in 1990–2006 to 34.59% (29.05–40.57) ( p =0.029). The highest NAFLD prevalence was in Latin America 44.37% (30.66%–59.00%), then Middle East and North Africa (MENA) (36.53%, 28.63%–45.22%), South Asia (33.83%, 22.91%–46.79%), South-East Asia (33.07%, 18.99%–51.03%), North America (31.20%, 25.86%–37.08%), East Asia (29.71%, 25.96%–33.76%), Asia Pacific 28.02% (24.69%–31.60%), Western Europe 25.10% (20.55%–30.28%). Among the NAFLD cohort diagnosed without a liver biopsy, pooled mortality rate per 1000 PY was 12.60 (6.68–23.67) for all-cause mortality; 4.20 (1.34–7.05) for cardiac-specific mortality; 2.83 (0.78–4.88) for extrahepatic cancer-specific mortality; and 0.92 (0.00–2.21) for liver-specific mortality. Conclusions: NAFLD global prevalence is 30% and increasing which requires urgent and comprehensive strategies to raise awareness and address all aspects of NAFLD on local, regional, and global levels.